Ashya Warner
Duncanville,TX
Summary
Accurate professional performs all aspects of medical billing, including coding, charge entry, transmission, correction, and resubmission. Brings several years of experience in working hand-in-hand with front office to validate proper information for claims processing. Detail-oriented and helpful professional with expertise in resolving billing issues and reviewing claim denials.Comprehensive training in ICD-10-CM, CPT and HCPCS coding systems.. Committed to implementing comprehensively organized billing and documentation policies, analysis, and interpretation of medical documentation, coordinating with medical providers to ensure care and preparing and submitting claims to insurance companies.
Overview
1
1
Certification
Work History
Medical Admin/Medical Coding and Billing Specialist
Golden Life Wellness Center
Duncanville, TX
- Verified pre-authorization requirements for procedures and medications. Completed necessary authorizations and insurance referrals accordingly.
- Submitted Specialist referrals through EHR system, accompanied by relevant Encounter notes and lab results.
- Spearheaded the training and supervision of Front Desk staff, resulting in improved customer satisfaction and streamlined workflows.
- Facilitated and Conducted interviews to evaluate candidate skills and experience for front desk positions.
- Ensured accuracy of patient demographics by consistently entering and updating information in the EHR system.
- Efficiently responded to numerous patient, provider, and insurance inquiries via phone
- Arranged collaborative lunch meetings with specialty companies to foster partnerships.
- Utilized EHR system to generate accurate superbills by cross-referencing information from encounters and care plan notes, and assigned appropriate ICD-10 and CPT codes with modifiers.
- Submitted Claims via Claim MD and resubmitted rejected claims
- Ensured timely resolution of claim appeals
- Utilized accounting software to send invoices directly to patients
- Ensured meticulous record-keeping by accurately recording payments and receipts in patients' files.
- Proficiently manage the company's email system and effectively respond to a wide range of insurance inquiries, patient communications, meeting arrangements, and information requests.
- Greeted and checked in patients, updating patient information in computer system.
- Processed referrals for specialist care when requested by physicians or patients.
Medical Administrative Assistant
Absolute Allied Community Health
Duncanville, TX
- Scanned documents into EHR systems according to established protocols.
- Greeted patients, verified insurance coverage and collected copayments.
- Ordered office supplies and maintained inventory levels of medical supplies.
- Verified patient eligibility for insurance coverage by contacting insurance carriers and obtaining the necessary authorization numbers.
- Created spreadsheets in Excel for tracking purposes.
- Maintained confidentiality of all patient information according to HIPAA regulations.
- Answered phones, scheduled appointments, and provided general information
- Maintained immunization records and documented all vaccine administration activities.
- Transmitted medical records and other correspondence by mail, e-mail, or fax.
- Interviewed patients to complete case histories and intake forms.
- Updated patient accounts and information daily.
- Maintained confidentiality of records relating to clients' treatment
Insurance/Prior Authorization Specialist
McKesson
Remote
- Completed verification of eligibility and benefits for procedures and office visits through Benefit Investigations.
- Processed and tracked referrals using software for Prior Authorizations.
- Enhanced accuracy and billability by properly verifying CPT and Diagnosis Codes.
- Worked directly with Insurance representative to confirm claims and ensure timely payment processing.
- Reviewed and modified patient insurance data as required to ensure accuracy and compliance with policy updates.
- Engaged in outbound calls with Insurance payers to assess treatment and procedure eligibility as well as benefits.
- Maintained accurate records of all authorization activities in the database system.
- Facilitated communication between providers, payers and health plans regarding prior authorization processes.
- Monitored trends in medical coding practices and implemented changes as needed.
- Provided guidance to providers on policy requirements and utilization management guidelines.
Medical Billing Specialist/Receptionist/Medical Assistant
Joshua L. Weiss M.D. Associated
Dallas , TX
- Logged rejected claims from insurers.
- Resubmitted claims as necessary to facilitate collection.
- Streamlined and monitored accounts to ensure efficient collection activity.
- Effectively managed payment collection for co-pays and deductibles.
- Conducted thorough insurance verification process.
- Elevated standards by acquiring required medical necessity documentation.
- Collaborated with medical professionals to ensure effective communication and coordination.
- Provided front desk support as needed, including patient check-in, appointment scheduling, and managing phone calls.
- Validated claim receipts for accuracy.
- Recorded patient/insurance payments and processed appeals.
- Answered and resolved patient billing inquiries through inbound and outbound phone calls.
- Guided patients to examination rooms and efficiently managed patient flow, ensuring timely and organized care.
- Entered and managed patient data in the EHR system for ultrasound procedures, ensuring accurate and up-to-date records.
Virtual Medical Scribe
Dr. David M. Headley MD
Remote
- Processed and collected payments and copays.
- Checked patients in for telehealth appointments.
- Verified patient's Insurance prior to appointments.
- Documented laboratory test results into patient charts.
- Verified patient insurance information following HIPAA regulations.
- Recorded diagnoses dictated by physicians.
- Updated patient demographics.
- Accurately and thoroughly documented medical encounters as they were being performed by the medical provider.
- Translated medical jargon and abbreviations into expanded forms to promote accuracy of patient and health care facility records.
- Set up and maintained medical files and databases.
- Provided administrative support to healthcare professionals by scheduling appointments and managing correspondence.
- Assisted physicians in patient care by transcribing and entering orders into the Electronic Medical Record system.
- Obtained accurate medical histories from patients and documented them into the EMR system.
Education
Certified Professional Coder
American Academy of Professional Coders
Remote01-2023
Medical Billing
Expert Rating Certified Professionals
Remote01-2022
Trade Diploma - Medical Office Administration
Remington College
Garland, TX04-2021
High School Diploma -
Duncanville High School
Duncanville, TX06-2018
Skills
- ICD 10
- CPT
- HCPCS
- Administrative skills
- EHR systems
- Account management
- Typing
- HIPAA
- Data Collection
- Insurance Verification
- Medical Terminology
- Time management
- Posting and balancing
- Medical Billing
- Document review
- Record maintenance
- Microsoft Office
- Organization
- Multi-Task Management
- Insurance Claim Filing
- Referrals and Authorizations
Certification
- Expert Training,Medical Billing Certification
- Medcerts, Medical Office Administrator Certified
- NHA,Certified Medical Administrative Assistant
- UDEMY,Certified Electronic Health Records Specialist sitting in 2024
- AAPC, Certified Professional Coder sitting in 2024
- BLS
References
References available upon request.
Timeline
Medical Admin/Medical Coding and Billing Specialist
Golden Life Wellness Center
Medical Administrative Assistant
Absolute Allied Community Health
Insurance/Prior Authorization Specialist
McKesson
Medical Billing Specialist/Receptionist/Medical Assistant
Joshua L. Weiss M.D. Associated
Virtual Medical Scribe
Dr. David M. Headley MD
Certified Professional Coder
American Academy of Professional Coders
Medical Billing
Expert Rating Certified Professionals
Trade Diploma - Medical Office Administration
Remington College
High School Diploma -
Duncanville High School
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